Floppy Eyelid Syndrome Leading to a Diagnosis of a Severe Obstructive Sleep Apnea

Authors: M. Karhanová 1;  M. Bienová 2;  M. Hobzová 3
Authors‘ workplace: Oční klinika LF UP a FN Olomouc, přednosta doc. MUDr. Jiří Řehák, CSc., FEBO 1;  Klinika chorob kožních a pohlavních, LF UP a FN Olomouc, přednosta doc. MUDr. Dagmar Ditrichová, CSc. 2;  Klinika plicních nemocí a tuberkulózy LF UP a FN Olomouc, přednosta prof. MUDr. Vítězslav Kolek, DrSc. 3
Published in: Čes-slov Derm, 87, 2012, No. 6, p. 229-232
Category: Case Reports


Floppy eyelid syndrome (FES) is a relatively rare condition of unknown etiology which pathophysiology is still not fully understood. Although the issue of eyelid diseases falls within the competence of an ophthalmologist, in this particular case the correct diagnosis and subsequent treatment success are based on a close interdisciplinary cooperation and good awareness on the issue. The aim of this report is to present a case of a patient with a primarily big “cosmetic“ problem with his eyelids. In the present case, the determination and recognition of FES and the general examinations ordered accordingly resulted in the diagnosis of a (at that time unrecognized) severe obstructive apnea (OSA). Subsequent treatment of OSA significantly increased the patient’s quality of life. Also his eye problems were alleviated.

Key words:
floppy eyelid syndrome – obstructive sleep apnea


1. BOULTON, J. E., SULLIVAN, T. J. Floppy eyelid syndrome and mental retardation. Ophthalmology, 2000, 107, p. 1989–1991.

2. BRADLEY, T. G., FLORAS, J. S. Obstructive sleep apnoea and its cardiovascular consequences. Lancet, 2009, 373, p. 82–93.

3. CULBERTSON, W. W., OSTLER, H. B. The floppy eyelid syndrome. Am. J. Ophtalmol., 1981, 92, p. 568–575.

4. DE SOUSA, A. G. P., CERCATO, C., MANCINI, M. C. et al. Obesity and obstructive sleep apnoea – hypopnoea syndrome. Complications of obesity. Obes. Rev., 2008, 9, p. 1–15.

5. EZRA, D. G., BEACONSFIELD, M., SIRA, C. et al. Long-term outcomes of surgical approaches to the treatment of floppy eyelid syndrome. Ophthalmology, 2010, 117, 4, p. 839–846.

6. KARGER, R. A., WHITE, W. A., PARK, W. C. et al. Prevalence of floppy eyelid syndrome in obstructive sleep apnea-hypopnea syndrome. Ophthalmology, 2006, 113, 9, p. 1669–1674.

7. KARHANOVÁ, M., HOBZOVÁ M. Floppy eyelid syndrom a obstrukční spánková apnoe. Čes. a slov. Oftal., 2012, 68, 1, p. 20–25.

8. KLOZAR, J. Jak odstranit chrápání? Interní Med., 2011, 13, 1, p. 51–53.

9. LAGFORD, J. D., LINBERG, J. V. A new physical finding in floppy eyelid syndrome. Ophtalmology, 1998, 105, p. 165–169.

10. MAZAL, Z. The floppy eyelid syndrom. Československá oftalmologie, 1990, 46, 6, p. 134–438.

11. McNAAB, A. A. Floppy eyelid syndrome and obstructive sleep apnoe. Ophtal. Plast. Reconstr. Surg., 1997, 13, p. 98–114.

12. McNAAB, A. A. Reversal of floppy eyelid syndrome with treatment of obstructive sleep apnoea. Clin. experiment. Ophtalmol., 2000, 28, p. 125–126.

13. McNAAB, A. A. The eye and sleep. Clin. Experiment Ophthalmol., 2005, 33, 2, p. 117–25.

14. NEVŠÍMALOVÁ, S., ŠONKA, K. et al. Poruchy spánku a bdění. Praha: Galén, 2007, 345 s.

15. SCHLOTZER-SCHREHARDT, U., STOJKOVIC, M., HOFMANN-RUMMELT, C. et al. The pathogenesis of floppy eyelid syndrome: involement and elastic fiber degradation. Ophtalmology, 2005, 112, p. 694–704.

16. ŠONKA, K. et al. Apnoe a další poruchy dýchání ve spánku. Praha: Grada, 2004, 247 s.

17. TKÁČOVÁ, R. Spánkové apnoe a ochorenia kardiovaskulárného systému. Praha: Galén, 2006, 194 s. 

18. YAGGI, H. K., CONCATO, J., KERNAN, W. N. et al. Obstructive sleep apnea as a risk factor for stroke and death. N. Engl. J. Med., 2005, 353, p. 2034–2041.

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